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September 16, 1983

Differentiation of Delirium From Dementia

Author Affiliations

St Louis University Medical Center

JAMA. 1983;250(11):1393-1394. doi:10.1001/jama.1983.03340110017021

To the Editor.—  We respond to "Organic Brain Syndrome: The Psychiatric Imposter" by Rubin et al (1983; 249:60), which described their attempt to identify organic brain syndrome in an emergency room population. Their screening criteria for delirium, essentially those of the Diagnostic and Statistical Manual of Mental Disorders (DSM III),1 were followed by the use of Jacobs' 30-item screening test2 to differentiate organic brain syndrome from functional psychosis. Although this test identifies severity of cognitive deficit, it is not designed to differentiate delirium from dementia or other organic brain syndromes.Delirium is one of the most frequently undiagnosed or misdiagnosed mental disorders in medical-surgical patients. Failure to recognize delirium, manage it well, and treat its underlying causes results in unnecessary morbidity and sometimes dementia or death.3,4 On the other hand, adequate treatment of delirium often brings prompt and gratifying improvement in the patient's clinical status.There is